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Radiology Coding Alert

Ultrasound:

76506-76999 Authoritative Guidelines Clear the Way to Cleaner Claims

Know where to look for nationally non-covered ultrasound services. When you report diagnostic ultrasound, be sure to check three main resources. Here are the can't-miss rules from Medicare's National Coverage Determinations (NCDs) Manual and CPT® guidelines, with a look at local coverage determinations (LCDs), too. NCD: Discover Covered Services in the Diagnostic Ultrasound NCD If you provide diagnostic ultrasound services to Medicare patients, take time to review section 220.5 of the NCD manual, "Ultrasound Diagnostic Procedures" (www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/ncd103c1_Part4.pdf). The NCD describes covered and non-covered services. Covered: The diagnostic ultrasound NCD lists dozens of nationally covered indications, which it refers to as Category I. For example, indications in the list include echocardiography, Doppler peripheral arterial flow study, and renal biopsy by ultrasonic guidance. Non-covered: There's also a section for nationally non-covered indications called Category II. "Techniques in Category II are considered experimental and should not be covered at this time," the [...]


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